ORS 415.063¹
Permissible use of compliance self-evaluative audit document by Oregon Health Authority
  • consideration of document in determining civil penalty

Permissible use of compliance self-evaluative audit document by Oregon Health Authority; consideration of document in determining of civil penalty. (1) ORS 415.062 (Compliance self-evaluative audit document privileged) does not prohibit the Oregon Health Authority from acquiring any compliance self-evaluative audit document or examining any person in connection with the document. If the authority determines that the actions of a coordinated care organization are egregious, the authority may introduce and use the document in any administrative proceeding or civil action under ORS 415.012 (Definitions for ORS 415.012 to 415.430) to 415.430 (Liability of member of CCO to pay provider for cost of care) or rules adopted pursuant to ORS 415.011 (Oregon Health Authority regulation of financial solvency of CCOs to align with regulation of domestic insurers).

(2) Any compliance self-evaluative audit document submitted to the authority under this section and in the possession of the authority remains the property of the coordinated care organization and is not subject to disclosure or production under ORS 192.311 (Definitions for ORS 192.311 to 192.478) to 192.478 (Exemption for Judicial Department).

(3)(a) The authority shall consider the corrective action taken by a coordinated care organization to eliminate problems identified in the compliance self-evaluative audit document as a mitigating factor when determining a civil penalty or other action against the coordinated care organization.

(b) The authority may, in the authority’s sole discretion, decline to impose a civil penalty or take other action against a coordinated care organization based on information obtained from a compliance self-evaluative audit document if the coordinated care organization has taken reasonable corrective action to eliminate the problems identified in the document.

(4) Disclosure of a compliance self-evaluative audit document to a governmental agency, whether voluntarily or pursuant to compulsion of law, does not constitute a waiver of the privilege set forth in ORS 415.062 (Compliance self-evaluative audit document privileged) for any other purpose.

(5) The authority may not be compelled to produce a compliance self-evaluative audit document. [2019 c.478 §18]

1 Legislative Counsel Committee, CHAPTER 415—Financial Regulation of Coordinated Care Organizations, https://­www.­oregonlegislature.­gov/­bills_laws/­ors/­ors415.­html (2019) (last ac­cessed May 16, 2020).
 
2 OregonLaws.org contains the con­tents of Volume 21 of the ORS, inserted along­side the per­tin­ent statutes. See the preface to the ORS An­no­ta­tions for more information.
 
3 OregonLaws.org assembles these lists by analyzing references between Sections. Each listed item refers back to the current Section in its own text. The result reveals relationships in the code that may not have otherwise been apparent. Currency Information